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We examined the joint associations of BMI category and grip strength tertile with risk of severe COVID-19 (inpatient COVID-19 or COVID-19 mortality) in 327 500 UK Biobank participants. Compared to normal-weight males with high grip strength, the odds ratio (95 % confidence interval) for males with obesity with low grip strength was 2.39 (1.59–3.60), but 1.52 (0.98–2.35) for males with obesity with a high grip strength. A higher grip strength did not appear to be associated with lower risk of severe COVID-19 in females. Muscle mass and strength development should be considered as a means to reduce risk of severe COVID-19 for males with obesity. [ABSTRACT FROM AUTHOR]

• Hematopoietic stem cell transplantation (HSCT) recipients have high rates of invasive pneumococcal disease (IPD). • Patients with multiple myeloma are at particularly higher risk of IPD following HSCT. • Compared with pneumococcal polysaccharide vaccine, pneumococcal conjugate vaccine significantly reduced IPD in HSCT recipients. • A nurse-led vaccination program produced high vaccination completion rates. Hematopoietic stem cell transplantation (HSCT) recipients are vulnerable to invasive pneumococcal disease (IPD), with reported IPD rates ranging from 3.81 to 22.5/1000 HSCT. This IPD risk could relate to immunodeficiency, low vaccination uptake, and poor immunogenicity of pneumococcal polysaccharide vaccine (PPV). Literature comparing the clinical effectiveness of pneumococcal conjugate vaccination (PCV) and PPV after HSCT is limited. In this retrospective analysis of HSCT recipients at our center from 2004 to 2015, we evaluated vaccination uptake and compared IPD rates in patients receiving PPV (pre-2010 group) and PCV (post-2010 group). IPD was determined from microbiological results for all HSCT recipients from January 2004 to June 30, 2019. Eight hundred patients had a total of 842 HSCT events, including autologous HSCT (auto-HSCT; n = 562) and allogeneic HSCT (allo-HSCT; n = 280). More than 90% of the HSCT recipients were enrolled, and >93% of surviving HSCT recipients completed the vaccination protocol. Fifteen IPD episodes occurred in 13 patients between 2004 and June 30, 2019. Thirteen episodes occurred in the pre-2010 group, even though 9 of 13 (69%) serotyped isolates were covered by PPV. Two episodes occurred in the post-2010 group; neither serotype was covered by PCV. Thus, with PCV introduction, IPD rate was significantly reduced from 38.5/1000 unique HSCTs pre-2010 to 4.0/1000 unique HSCTs post-2010 (P <.001). A significant reduction was seen in both auto-HSCTs (from 29.4 to 3.1 /1000 unique auto-HSCTs; P =.011) and allo-HSCTs (from 58.3 to 5.6/1000 unique allo-HSCTs; P =.011). PCV demonstrated superior clinical effectiveness over PPV, highlighting its importance in preventing infectious complications after HSCT. Robust vaccination programs at transplantation centers are needed to optimize vaccination uptake and completion. [ABSTRACT FROM AUTHOR]

Highlights • A multi-level safety climate scale was developed for air freight handling. • Organization and group-level safety climate sub-dimensions were identified. • The industry-specific safety climate scale was validated using an independent sample. • Safety climate sub-dimensions were positively related to self-reported safety behaviors. • Incremental validity of industry-specific scale items was assessed. Abstract Safety is of critical importance in many industries. One of the more dangerous environments in industry, and the military, is air freight handling, where the fatal injury rate has consistently been higher than the national average. Nonetheless, peer-reviewed safety research that is focused on air freight handling is practically non-existent. Therefore, research that helps academicians and managers better understand safety climate and its potential influence on employee attitudes and behaviors is vitally important. To address these concerns, we develop and validate an air freight handling-specific safety climate scale capable of capturing employees' safety climate perceptions at the organization and group levels. We also found that, in general, measurement scale dimensions in this context are like those in other high-risk, transportation-related contexts, and that the nomological network may be converging on a cross-context set of safety climate dimensions. The resultant scale can be used to investigate safety climate's relationship with various employee attitudes, safety and operational behaviors in this high-risk environment. [ABSTRACT FROM AUTHOR]

Abstract This paper reviews recent hydrological risk assessment, communication and early warning systems and proposes a framework to reformulate the classic view of Early Warning and Monitoring Systems towards a participatory one. The new framework is developed for flood risks (from multiple flood hazards), using examples from selected Nordic and other European countries. The study shows a potential for public participation in all stages of the Disaster Risk Reduction (DRR) cycle, with enhanced risk communication and awareness. Web-based access to hydrological data and nationwide modelling results can support adaptive and integrated management and learning about the flood risks on catchment scale. This can help identify cost-efficient solutions with synergy to other policy goals. The study shows how social media and digitalisation initiatives in the Nordic countries can support web-based access to historical data, real-time forecasts, and climate projections. Furthermore, the web-based access to data and model results can provide a coherent and integrated platform for stakeholder interaction and co-production for planning and decision-making that integrate hazard and risk knowledge. This can increase societal resilience and flood risk assessment across community and sector boundaries with proper analysis of risk areas, trade-off in costs and benefits of different solutions, and optimisation of climate change adaptation at the catchment scale. [ABSTRACT FROM AUTHOR]

• The proportion of prostate cancer patients diagnosed by transperineal biopsy has increased. • This is now the predominant form of prostate cancer diagnosis in Australia and New Zealand. • Transperineal biopsy use varies between jurisdictions, hospitals, and patient groups. To describe changes in the use of prostate biopsy techniques among men diagnosed with prostate cancer in Australia and New Zealand and examine factors associated with these changes. We extracted data between 2015 and 2019 from 7 jurisdictions of the Australia and New Zealand Prostate Cancer Outcomes Registry (PCOR-ANZ). Distribution and time trend of transrectal (TR) vs. transperineal (TP) biopsy type, differences in the proportion of biopsy type by geographic jurisdiction, diagnosing institute characteristics (public vs. private, metropolitan vs. regional, case volume) and patient characteristics such as socio-economic status (SES), and location of residence were analyzed. We analyzed data from 37,638 patients. The overall proportion of prostate cancer diagnosed by TP increased from 26% to 57% between 2015 and 2019. Patients living in a major city, a more socioeconomically advantaged area or who were diagnosed in a metropolitan or private hospital were more likely to have TP than TR. While all subgroups were observed to increase their use of TP over the study period, uptake grew faster for men from low SES areas and those diagnosed at a regional or low-volume hospital but slower for men living in outer regional/remote areas or treated at a public hospital. In this binational registry, prostate cancer is now more commonly diagnosed by TP than the TR approach. While the gap between uptakes of TP has diminished for patients with low vs. high SES, disparity has widened for patients from outer regional areas vs major cities and public vs. private hospitals. [ABSTRACT FROM AUTHOR]

A systematic review to identify risk factors for prostate biopsy-related infection, preventative strategies, and optimal management of infectious complications was conducted. Significant risk factors for postbiopsy infection include urogenital infection, antibiotic use, international travel, hospital exposure, bacteriuria, previous transrectal biopsy, and resistance of fecal flora to antibiotic prophylaxis (especially fluoroquinolones). Patients at risk may benefit from an adjusted biopsy protocol comprising transrectal biopsy under targeted prophylaxis, and/or the use of rectal disinfection techniques or using a transperineal approach. Management of biopsy-related infection should be based on individual risk and local resistance profiles with input from multiple specialties. [ABSTRACT FROM AUTHOR]

This paper examines spatial effects on hybrid-electric vehicle (HEV) adoption. This is in contrast to most existing analyses, which concentrate on analyzing socioeconomic factors and demographics. This paper uses a general spatial model to estimate the strength of ‘neighbor effects’ on HEV adoption—namely that each consumer’s HEV-adoption decision can be influenced by the HEV-adoption decisions of geographic neighbors. We use detailed census tract-level demographic data from the 2010 United States Census and the 2012 American Community Survey and vehicle registration data collected by the Ohio Bureau of Motor Vehicles. We find that HEV adoption exhibits significant spatial effects. We further conduct a time-series analysis and show that historical HEV adoption has a spatial effect on future adoption. These results suggest that HEVs may appear in more dense clusters than models that do not consider spatial effects predict. [ABSTRACT FROM AUTHOR]

Purpose Vesicourethal anastomosis (VUA) during radical prostatectomy can be achieved using various suture plication techniques. Traditionally, an indwelling urinary catheter remains in-situ to facilitate the healing process of the reconstructed VUA. Compromise or rupture of this anastomosis may lead to acute urinary leak and subsequent urinoma or stricture formation. This ex-vivo porcine model aims to evaluate VUA tensile strength using different suture techniques and catheter types. Methods Male porcine bladders were obtained and prostatectomy was performed. The specimens were randomized and VUA were created using 3-point interrupted, 6-point interrupted or 6 point continuous 3-0 monocryl suture. 20Fr catheters were utilized, specifically varying manufacturers (A and B) and catheter balloon shapes (round versus oval). The VUA model was placed within a reproducible pulley system and graduated weights were applied until failure of the catheter balloon or the model VUA. Model failure was defined as either ‘VUA rupture’ , ‘Catheter passage through VUA’ or ‘catheter failure’. Results Twenty consecutive porcine bladders were prepared, tested and utilized for analysis. VUA reconstructed with 3-point fixation was more likely to suffer VUA rupture ( p =0.025) compared to 6-point interrupted or 6-point continuous VUA. Higher tensile pressure causing catheter balloon rupture ( p =0.009) was observed for Manufacturer A. Catheters with oval-balloon shape were more likely to dislodge past the VUA without disruption of the anastomosis ( p =0.002). Conclusions During prostatectomy, anastomotic technique and catheter selection can significantly alter the tensile properties of the VUA. Further research is required to validate our findings in clinical models. [ABSTRACT FROM AUTHOR]

Background and Objective: Radical prostatectomy (RP) is a common and widely used treatment for localized prostate cancer. Sequela following RP may include urinary incontinence and sexual dysfunction, outcomes which are recorded within a bi-national Prostate Cancer Outcomes Registry. The objective was to report population-wide urinary incontinence and sexual function outcomes recorded at 12 months following RP; and to quantify and explore factors associated with variation in outcome.Materials and Methods: The Prostate Cancer Outcomes Registry of Australia and New Zealand (PCOR-ANZ) was used for this study. Participants were treated with radical prostatectomy between 2016 and 2020. Domain summary scores for urinary incontinence and sexual function from the EPIC-26 instrument were the main outcomes, taken at 12 months following surgery (6-18 months). "Major" urinary and sexual function bother were also assessed. Variation in outcomes was investigated using linear and logistic multivariable regression models adjusted for covariates: age, socioeconomic status, PSA at diagnosis, surgical technique, surgical specimen grade group, margin status, and clinician surgical volume.Results and Conclusions: The analytic cohort included 13,083 men with the mean urinary incontinence domain score being 76/100 (SD = 25) with 9.2% reporting major bother. For sexual function, the mean score was 29/100 (SD = 26) with 46% reporting major bother. Of the examined variables, age at surgery and surgical volume category were most predictive of function, with disparities exceeding minimally important differences, though large variation was observed between urologists within volume categories. There is considerable variation in 12-month postprostatectomy functional outcomes. Variation is explained by both patient and clinician factors, though some confounders are unmeasured in this cohort. [ABSTRACT FROM AUTHOR]

Background Atorvastatin and metformin are known energy restricting mimetic agents that act synergistically to produce molecular and metabolic changes in advanced prostate cancer (PCa). This trial seeks to determine whether these drugs favourably alter selected parameters in men with clinically-localized, aggressive PCa. Methods/design This prospective phase II randomized, controlled window trial is recruiting men with clinically significant PCa, confirmed by biopsy following multiparametric MRI and intending to undergo radical prostatectomy. Ethical approval was granted by the Royal Brisbane and Women's Hospital Human and The University of Queensland Medical Research Ethics Committees. Participants are being randomized into four groups: metformin with placebo; atorvastatin with placebo; metformin with atorvastatin; or placebo alone. Capsules are consumed for 8 weeks, a duration selected as the most appropriate period in which histological and biochemical changes may be observed while allowing prompt treatment with curative intent of clinically significant PCa. At recruitment and prior to RP, participants provide blood, urine and seminal fluid. A subset of participants will undergo 7Tesla magnetic resonance spectroscopy to compare metabolites in-vivo with those in seminal fluid and biopsied tissue. The primary end point is biochemical evolution, defined using biomarkers (serum prostate specific antigen; PCA3 and citrate in seminal fluid and prostatic tissue). Standard pathological assessment will be undertaken. Discussion This study is designed to assess the potential synergistic action of metformin and atorvastatin on PCa tumour biology. The results may determine simple methods of tumour modulation to reduce disease progression. [ABSTRACT FROM AUTHOR]